NCLEX-RN | QB2 | Practice Exam #18 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. A client underwent ileostomy, when should the drainage appliance be applied to the stoma?
- 24 hours later, when edema has subsided.
- In the operating room.
- After the ileostomy begin to function.
- When the client is able to begin self-care procedures.
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2. A client is being prepared for a thoracentesis. The nurse should assist the client to which position for the procedure?
- Lying in bed on the affected side
- Lying in bed on the unaffected side
- Sims position with the head of the bed flat
- Prone with the head turned to the side and supported by a pillow
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3. Situation: The OR is divided in three zones to control traffic flow and contamination.Q. Multiple vial-dose-insulin when in use should be:
- Kept at room temperature
- Kept in the refrigerator
- Kept in narcotic cabinet
- Store in the freezer
4. Which of the following is TRUE about the auscultation of blood pressure?
- Pulse + 4 is considered as FULL
- The bell of the stethoscope is use in auscultating BP
- Sound produced by BP is considered as HIGH frequency sound
- Pulse +1 is considered as NORMAL
5. Which among the following person is most susceptible to leprosy?
- Mark, 21 year old athlete
- Arvinn, 16 year old student
- JC, 12 year old student
- Clarence, 9 year old student
6. She theorized that man is composed of sub and supra systems. Subsystems are cells, tissues, organs and systems while the suprasystems are family, society and community.
- Roy
- Rogers
- Henderson
- Johnson
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7. Which of the following is given to the pregnant woman?
- Chloroquine
- Iron
- iodized oil capsule
- All of the above
8. The nurse is caring for a client who is to undergo a lumbar puncture to assess for the presence of blood in the cerebrospinal fluid (CSF) and to measure CSF pressure. Which result would indicate n abnormality?
- The presence of glucose in the CSF.
- A pressure of 70 to 200 mm H2O
- The presence of red blood cells (RBCs) in the first specimen tube
- A pressure of 00 to 250 mmH2O
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9. Which type of evaluation occurs continuously throughout the teaching and learning process?
- Summative
- Informative
- Formative
- Retrospective
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10. Which of the following is an epidemiologic function of the nurse during an epidemic?
- Conducting assessment of suspected cases to detect the communicable diseases
- Monitoring the condition of the cases affected by the communicable disease
- Participating in the investigation to determine the source of epidemic
- Teaching the community on preventive measures against the disease
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11. The nurse has performed nutritional teaching on a client with gout who is placed on a low- purine diet Which selection by the client would indicate that teaching has been ineffective?
- Boiled cabbage
- Apple
- Peach cobbler
- Spinach
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12. The nurse caring for a mobile patient with a destroyed tympanic membrane and an intact stapes. What type of repair process should the nurse anticipate?
- Myringoplasty
- Tymoanostapedopexy
- Cavum minor
- Tympanoplasty and fenestration of lateral semicircular canal
13. The client has recently returned from having a thyroidectomy. The nurse should keep which of the following at the bedside?
- A tracheotomy set
- A padded tongue blade
- An endotracheal tube
- An airway
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14. Which of the following goal take PRIORITY when recovering from general anesthesia in post anesthesia care unit (PACU)?
- hermoregulation
- elastic skin turgor
- latent airway
- patient voids freely
15. A female client with cancer has radium implants. The nurse wants to maintain the implants in the correct position. The nurse should position the client:
- Flat in bed.
- On the side only.
- With the foot of the bed elevated.
- With the head elevated 45-degrees (semi-Fowler's).
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16. A client with anorexia nervosa tells a nurse she always feels fat Which of the following interventions is the best for this client?
- Talk about how important the client is.
- Encourage her to look at herself in a mirror
- Address the dynamics of the disorder.
- Talk about how shes different from her peers.
17. A female client tells the clinic nurse that her skin is very dry and irritated. Which product would the nurse suggest that the client apply to the dry skin?
- glycerin emollient
- aspercreame
- myoflex
- acetic acid solution
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18. A client's medication order reads, "Thioridazine (Mellaril) 200 mg P.O. q.i.d. and 100 mg P.O. p.r.n." The nurse should:
- administer the medication as prescribed.
- question the physician about the order.
- administer the order for 200 mg PO. q.i.d. but not for 100 mg PO. p.r.n.
- administer the medication as prescribed but observe the client closely for adverse effects.
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19. A client with schizophrenia is receiving Haloperidol (Haldol) 5 mg ti.d.. The client's family is alarmed and calls the clinic when "his eyes rolled upward." The nurse recognizes this as what type of side effect?
- Oculogyric crisis
- Tardive dyskinesia
- Nystagmus
- Dysphagia
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20. Situation: You are assigned in the Orthopedic Ward where clients are complaining of pain in varying degrees upon movement of body parts.Q. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?
- Instruct client to observe strict bed rest
- Check for epidural catheter drainage
- Administer analgesia through epidural catheter as prescribed
- Assess respiratory rate carefully
21. Situation: During surgical operation, it is inevitable to utilize sutures. The nurse should know the basic principles in suturing as well as knowledge in selecting sutures and caring for clients with sutures.Q. In suturing the internal organs such as kidneys, liver, spleen, pancreas and stomach, the nurse knows that the type of suture material that the physician will most likely use is:
- Steel
- Vicryl
- Cotton
- Silk
22. Which of the following is a natality rate?
- Crude birth rate
- Neonatal mortality rate
- Infant mortality rate
- General fertility rate
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23. A 37-year-old client with uterine cancer asks the nurse, Which is the most common type of cancer in women?" The nurse replies that it's breast cancer. Which type of cancer causes the most deaths in women?
- Breast cancer
- Lung cancer
- Brain cancer
- Colon and rectal cancer
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24. Situation: Sexually Transmitted Diseases are important to identify during pregnancy because of their potential effect on the pregnancy, fetus, or newborn. The following questions pertain to STD s.Daphne who is on her first trimester of pregnancy is also infected with trichomoniasis. You know that the drug of choice for Daphne is:
- Clotrimazole (topical)
- Monistat
- Zovirax
- Fagyl
25. A home health nurse is setting up a medication administration schedule for an elderly patient The patient is talking Oscal (calcium corbonate), Feosol (ferrous sulfate), and Orazinc (Zinc sulfate). The patient eats meals at 8:00 AM, 12 noon, and 6:00 PM. Which of the following medication administration times would the nurse MOST likely implement for this patient?
- Oscal, Orazinc, and foesal at 8:00AM
- Oscal at 6:00AM, Orzinc at 12:00 noon, Foesal At 4:00PM
- Oscal and Foesal at 12:00 noon and Orazinc at 6:00PM
- Orazinc at 6:00 AM, Oscal at 12:00 noon, and Foesal at 6:00PM
26. The nurse is caring for a client in labor. Which assessment findings indicate to the nurse that the client is beginning the second stage of labor? Select all that apply. 1.The contractions are regular. 2.The membranes have ruptured. 3.The cervix is dilated completely. 4.The client begins to expel clear vaginal fluid. 5.The spontaneous urge to push is initiated from perineal pressure.
- 3,5
- 1,4,5
- 2,3,5
- 1,2,3,4
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27. A 6-year-old child with human immunodeficiency virus (HIV) infection has been admitted to the hospital for pain management. The child asks the nurse if the pain will ever go away. The nurse should make which best response to the child?
- "The pain will go away if you lie still and let the medicine work”
- "Try not to think about it The more you think it hurts, the more it will hurt"
- "Every time it hurts,press on the call button and I will give you something to make the pain go all away.”
- "I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less"
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28. While caring for a client with cervical cancer the nurse notes that the radioactive implant is lying in the bed. The nurse should:
- Place the implant in a biohazard bag and return it to the lab.
- Give the client a pair of gloves and ask her to reinsert the implant.
- Use tongs to pick up the implant ana return it to a lead-lined container
- Discard the implant in the commode and double-flush.
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29. Postulated the INTERPERSONAL ASPECT OF NURSING
- Travelbee
- Swanson
- Zderad
- Peplau
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30. A nurse is caring for an eight year-old male with cystic fibrosis. Based on the nurses understanding of the disease what nursing intervention should the nurse expect to perform?
- Restrict sodium and fluid intake
- Give antidiarrheal medications
- Discourage coughing after postural drainage
- Administer pancreatic enzymes with each meal
31. Situation: Manny, 6 years old was admitted at Cardinal Santos Hospital due to increasing frequency of bowel movements, abdominal cramps and distension.Q. Diarrhea is said to be the leading cause of morbidity in the Philippines. Nurse Harry knows that diarrhea is present if:
- passage of stool is more than 3 bowel movements per week
- passage of stool is less than 3 bowel movements per day
- passage of stool is more than 3 bowel movements per day
- passage of stool is less than 3 bowel movements per week
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32. A patient is in labor and has just been told she has a breech presentation. The nurse should be particularly alert for which of the following?
- Quickening
- Ophthalmia neonatorum
- Prolapsed umbilical cord
- Pica
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33. A client with severe blood loss resulting from multiple trauma requires rapid transfusion of several units of blood. The nurse asks another health team member to obtain which device for use during the transfusion procedure to help reduce the risk of cardiac dysrhythmias?
- Infusion pump
- Pulse oximeter
- Cardiac monitor
- Blood-warming device
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34. Micronutrient supplementation is included In what program of the DOH?
- Expanded program on Immunization
- Reproductive Health
- Araw ng Sangkap Pinoy
- Sentrong sigla
35. The nurse is observing the ambulation of a client recently fitted for crutches. Which observation requires nursing intervention?
- Two finger widths are noted between the axilla and the top of the crutch.
- The client bears weight on his hands when ambulating.
- The crutches and the clients feet move alternately.
- The client bears weight on his axilla when standing.
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36. The district nurse visits a 30 year-old woman at home following the delivery of her second child, a full term girl. Following the delivery of her first child, she had developed a breast infection and stopped breastfeeding because of the pain. She asks the nurse how she can best prevent it with this infant. What is the most appropriate response?
- Provide feedings on demand
- Apply vitamin E cream to the nipples
- Request a prophylactic antibiotic
- Apply heat to the breasts after feedings
37. The following are types of breech presentation EXCEPT:
- Footling
- Frank
- Complete
- Incomplete
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38. Functional nursing has some advantages, which one is an EXCEPTION?
- Psychological and sociological needs are emphasized.
- Great control of work activities.
- Most economical way of delivering nursing services.
- Workers feel secure in dependent role
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39. A patients chart is what type of data source?
- Primary
- Secondary
- Tertiary
- Can be A and B
40. Jimmy a 2-year old child revealed baggy pants. As a nurse, using the IMCI guidelines, how will you manage Jimmy?
- Refer the child urgently to a hospital for confinement.
- Coordinate with the social worker to enroll the child in a feeding program.
- Make a teaching plan for the mother, focusing on menu planning for her child.
- Assess and treat the child for health problems like infections and intestinal parasitism.
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41. A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis?
- The couple has established a set schedule for their sexual encounters.
- The couple has been married for more than eight years.
- The couple lives with one set of parents.
- The couple has close friends who gave birth to a baby within the last year.
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42. Situation Joint Commission on Accreditation of Hospital Organization (JCAHO) patient safety goals and requirements include the care and efficient use of technology in the OR arid elsewhere in the healthcare facility.Q. Over dosage of medication or anesthetic can happen even with the aid of technology like infusion pump, sphygmomanometer, and similar devices/machines. As a staff, how can you improve the safety of using infusion pumps?
- Check the functionality of the pump before use
- Select your brand of infusion pump like you do with your cellphone
- Allow the technician to set the; infusion pump before use
- Verify the flow rate against your computation
43. When developing an initial nursing care plan for a male client with a Bipolar I disorder (manic episode) nurse Ron should plan to?
- Isolate his gym time
- Encourage his active participation in unit programs
- Provide foods, fluids and rest
- Encourage his participation in programs
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44. Situation: Nursing informatics is a way of using information technology computers and the internet in the improvement of nursing care. The first nursing informatics conference was held during 1977.Q. This is a type of a computerized recording system that enables hospitals to organize various data such as admission, records, clinical laboratory, pharmacy, inventory and finance.
- Management information system
- Hospital information system
- University information system
- Government information system
45. A nurse is caring for a child who is post-tonsillectomy and adenoidectomy. The nurse should plan to assess which of the following complications?
- Pulmonary hypertension
- Hemorrhage
- Hearing loss
- Corpulmonal
46. A client has had radical neck dissection and begins to hemorrhage at the incision site. The nurse should take which actions in this situation? Select all that apply. 1.Monitor vital signs. 2.Monitor the client's airway. 3.Apply manual pressure over the site. 4.Lower the head of the bed to a flat position. 5.Call the health care provider (HCP) immediately.
- 1,2,3,4,5
- 1,2,3,5
- 2,3,5
- 1,4,5
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47. Which of the following is NOT TRUE about the Kardex
- It provides readily available information
- It is a tool of end of shift reports
- The primary basis of endorsement
- Where Allergies information are written
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48. The nurse is ordered to administer ampicillin capsule TID p.o. The nurse should give the medication
- Three times a day orally
- Three times a day after meals
- Two time a day by mouth
- Two times a day before meals
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49. Situation: Michelle is a 6 year old preschooler. She was reported by her sister to have measles but she is at home because of fever, upper respiratory problem and white sports in her mouth.As a public health nurse, you teach mother and family members the prevention of complication of measles. Which of the following should be closely watched?
- Temperature fails to drop
- Inflammation of the conjunctiva
- Inflammation of the nasopharynx
- Ulcerative stomatitis
50. Which of the following is NOT an attribute of a professional?
- Concerned with quantity
- Self directed
- Committed to spirit of inquiry
- Independent
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